The study was completed by interviewing nine private insurers who, together, cover roughly 110 million Americans.
While 46 percent of survey respondents’ beneficiaries were involved in one of the new payment programs three years ago, that number has grown to 62 percent. By 2017, 75 percent of beneficiaries are expected to be involved in pay-for-performance and financial risk-sharing arrangements, according to the study.
Insurers have been tightening coverage evidence requirements for innovative medical technologies since many new provider payment models emphasize cost reduction, which may limit patients’ access to new medical devices and technologies due to insurers raising the requirements for approving coverage of these items, according to the study.
Forty percent of the survey respondents believe it will become more difficult for technologies that are clinically appropriate but costly to gain coverage.
The study’s findings suggest an uncertain payment environment for insurance providers and for future investments in innovative medical technology.
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